Clinical Outcomes of Gram-negative Bacterial Peritonitis.
- Author:
Jaeseok YANG
1
;
Curie AHN
;
Se Han LEE
;
Jae Wook LEE
;
Woo Kyung CHUNG
;
Kook Whan OH
;
Ji Young KIM
;
Joo Won KIM
;
Kwon Wook JOO
;
Yon Soo KIM
;
Jin Suk HAN
;
Suhnggwon KIM
;
Jung Sang LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Korea. curie@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Peritoneal dialysis;
Peritonitis;
Gram-negative bacteria;
Pseudomonas;
Outcome
- MeSH:
Acinetobacter;
Catheters;
Gram-Negative Bacteria;
Hospitalization;
Humans;
Peritoneal Dialysis;
Peritonitis*;
Prognosis;
Pseudomonas;
Retrospective Studies;
Risk Factors;
Seoul;
Serum Albumin;
Soft Tissue Infections
- From:Korean Journal of Nephrology
2003;22(4):433-444
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Peritonitis which is still the most important cause of morbidity and technical failure in peritoneal dialysis even though it has decreased significantly, has been known to lead to different outcomes by the type of causative pathogens. METHODS: To analyze clinical outcomes with trends of peritonitis rates by the type of causative pathogens, we retrospectively reviewed peritoneal dialysis patients in Seoul National University Hospital from 1995 to 2001. RESULTS: Three hundred fifty-seven cases of peritonitis occurred in 163 patients among total 307 peritoneal dialysis patients and the rate of peritonitis was 0.44 episodes/patient-year. There are 130 (38.1 %) episodes of Gram-positive bacterial peritonitis, 59 (17.3%) episodes of Gram-negative bacterial peritonitis and 25 (7.3%) episodes of mixed bacterial peritonitis. E.coli, Acinetobacter, and Pseudomonas were main Gram-negative isolates, in the order named. The rate of total peritonitis and the rate of Gram- positive peritonitis decreased significantly during the study period. But, the rate of Gram-negative peritonitis remained constant, and therefore its relative proportion tended to increase. Among Gram-negative bacteria, the proportion of Pseudomonas species declined persistently. Gram-negative peritonitis was a significant risk factor of hospitalization, independent of soft tissue infection and serum albumin, like S.aureus peritonitis. In Gram-negative peritonitis or Pseudomonas peritonitis, more catheters were removed regardless of soft tissue infection or peritoneal dialysis duration. CONCLUSION: In conclusion, we confirmed Gram- negative peritonitis and Pseudomonas peritonitis have poor prognosis. Therefore, Cautious evaluation of abdominal lesions and aggressive treatment are necessary for patients with Gram-negative peritonitis whose relative proportion increased.
